AI is rapidly transforming utilization management—enabling faster case identification, earlier intervention and more consistent medical necessity decisions. But automation alone isn’t enough. Without clinical context and physician oversight, AI can introduce new risks alongside its benefits.
In this webinar, Dr. Jennifer Weinberg and Dr. Ronald Hirsch explore how leading organizations are using AI to enhance, not replace, clinical judgment, shifting utilization management from reactive denial defense to proactive clinical governance.
You’ll learn:
Where AI delivers the most value in utilization management, and where clinical expertise remains essential
How AI enables earlier identification of payer risk to support proactive, defensible decision-making
Why the physician advisor role is evolving from reactive firefighter to strategic clinical leader
A practical framework for balancing clinical defensibility and payer risk when prioritizing cases
